Hope
Beneath the 6 inches of new snow in the Northeast, there is evidence of spring. The skunk cabbage spears could be seen at the edge of the steams, and small carpets of moss appeared greener. Birds are beginning to show their breeding colors and behaviors. The Omicron variant is receding and the CDC is altering guidelines. You can now search your county's risk, based on a combination of vaccination rates, virus presence, and hospital capacity in your community.
While there is hope, uncertainty continues. When will the next COVID variant appear? How severe will it be? We don't know. But we have moved forward in this pandemic. Two years later we have vaccines and treatments. Science is charting a path forward. During my career the HIV virus went from a death sentence to a chronic disease, and now we have medications to prevent transmission and perhaps vaccines.
But there is much that science cannot help us understand.
I am struck with the human impetus to seek hope, rather than giving into disillusionment and the finality of death. My soon-to-be 92 year-old mother had a stroke this past July which limited her use of the left side of her body and also increased her confusion. She seems lucid much of the time, but continues to try to stand and hopes to walk again. Both of which are impossible. She never would have wanted to live this way in her earlier days: dependent on others to move her, bathe her, change her, and dress her. But she is very much "in the game" and says she is not ready to join my father who died 6 years ago. However, she feels his presence on the second floor. Is it heaven, which is consistent with her Catholic faith? Or is she remembering his desk on the second floor of the farm house or their condo before they moved to their cottage at the senior living complex? When asked, she cannot say.
What is next after this life on earth? Truth be told we don't know, although religions and cultures have fashioned answers. Many believe there is something more. Do we assume the form of another living being: an eagle, a cow, or a monk? Is there a purgatory, hell, or heaven as Dante described? Those who have died and returned to life, the near death experience, have powerful stories about the event which provides hope of something more after death.
In the US, we in health care have a hard time letting go. My mother's older sister is 98. She played the piano and organ for years and now suffers from a painful neuropathy, pins and needles in her fingers. She prays to die. While her physicians honor the request for no further hospitalizations, they are still ordering x-rays to follow her pneumonia and want to start her on a 3rd course of antibiotics and steroids. At what point is this futile and heartless?
COVID forced health care teams to do a better job with end of life discussions and talking with families about treatments that no longer benefited their loved ones. But we are not a profession that quits easily. Letting go and loss of life is hard. We have not yet fully shifted to guiding patients toward good deaths.
Hope can be denial of the inevitable. Hope side steps grief. It is also a way forward through uncertainty. It fosters resilience. Life is continuous change and hence uncertainty is always part of the picture until we master the next chapter or come to terms with our inability to do so.
I have looked to nature as a reminder of the birth-life-death and inevitable rebirth cycle. But climate change points out that finiteness. May we balance hope and reality. May we find the wisdom to act accordingly.